Cacciabaudo, Jean Marie

Cacciabaudo, Jean Marie is an individual health care provider with primary practice located at 540 Union Blvd , West Islip NY 11795-3105. She recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as her primary health care specialty. Cacciabaudo, Jean Marie can be contacted via phone (631) 669-2555.

Contact Information

Primary practice address
540 Union Blvd West Islip NY 11795-3105
Phone: (631) 669-2555
Fax: (631) 669-5787
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 186646 New York

Profile Details

NPI number 1497778930
LBN Legal business name Cacciabaudo, Jean Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated Oct 1st, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1497778930 NPPES
New York MEDICAID 01452666

Popular Providers